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S Adámek

Publications and source records attributed to S Adámek.

18 recordsLinked to original sources
PubMed2006

Surgical anatomy of parathyroid glands with emphasis on parathyroidectomy.

Number, location and surrounding structures of parathyroid glands with emphasis on parathyroidectomy were studied on 101 cadaverous bodies. Number of collected samples from all known locations of parathyroid glands varied from three to five in one individual, with mean 3.71 +/- 0.62. We identified 80% of samples as parathyroid glands. Mean number of correctly identified parathyroid glands in one individual was 2.77 +/- 1.06. The rest 20% of collected samples were lymph nodes, fat particles and thyroid or lipothymic tissue. Almost 30% more of inferior parathyroid glands were found in abnormal position in lipothymic tissue in comparison with their superior counterparts. We found several abnormities of vessels and cervical extensions of thymus. We also present case of brachiocephalic trunk, reaching the inferior pole of thyroid gland. We recommend beginning of parathyroidectomy in circumscribed area 2 cm in diameter, 1 cm cranially to the intersection of the inferior thyroid artery and recurrent laryngeal nerve followed by preparation on dorsal surface of thyroid gland, along the course of inferior thyroid artery and recurrent laryngeal nerve, in cervical extensions of thymus and in paraoesophageal and retropharyngeal region. Success of parathyroidectomy is based on the knowledge and experience of surgeon.

Adult↗
PubMed2005

[Our experiences with surgical treatment of iatrogenic colon perforation].

Coloscopy is a routine examination of high effectiveness. From the surgical point of view it has two main risks. The first one is the bleeding after endoluminal polypectomy. The other one is the perforation of the gut which is a severe and possibly lethal complication. We report on 6 iatrogenic colon perforations and its outcome.

Colonic Diseases↗
PubMed2005

[Surgical therapy of primary hyperparathyroidism and it's complications. Experience with 453 patients].

453 patients underwent surgery for primary hyperparathyreoidism between 1994 and 2003. In all patients, biochemical parameters were monitored and X-ray with USG of the neck was done. Struma nodosa was concommitantly present in 48 % of treated patients with primary hyperparathyroidism. In such cases, MRI offers better resolution of soft tissues. 98.6 % of treated patients had postoperative decrease of blood calcium to normal level. 5.4 % of cases were reoperations for primary hyperparathyroidism. In 12 % of cases, pathologically changed parathyroid glands in dystopic localization were found. In these dystopic localizations, pathologic parathyroid glands were found: in 3 % intrathyroid, in 7 % mediastinal and in 2 % of all 453 cases in other localization. In 4 % of patients, sternotomy was necessary. Persistent hypocalcemia was not registered in any patient. Transient hypocalcemia with necessity of infusion therapy was observed in 3.5 % of patients. Postoperative hypercalcemia persisted in 1.2 % of patients. Recurrent hypercalcemia was present in 0.2 % of cases. In three cases (0.7 %), unilateral injury of recurrent laryngeal nerve was observed.

Adenoma↗
PubMed2004

Surgical contribution to the management of primary hyperparathyroidism.

Surgical management of primary hyperparathyroidism is a very effective method. The target is to cure primary hyperparathyroidism and to reach normal calcium levels. This results in an improvement of health condition and resolution or at least moderation of symptoms. Complications are infrequent and mortality is very low. Surgical management is definite, safe and effective. Authors of this article address the diagnosis of primary hyperparathyroidism, clarify bone, metabolic and biochemical syndromes and present series of 151 patients that have been operated on at the 3rd Department of Surgery of the Motol University Hospital, Prague, with the diagnosis of primary hyperparathyroidism. The survey is focused on the primary hyperparathyroidism concomitant diseases and on the possible sequelae in the postoperative period.

Adolescent↗
PubMed2003

Long release latencies are increased by acetylcholine at frog endplate.

Uni-quantal endplate currents (EPCs) were recorded extracellularly at the frog neuromuscular synapse and their latency dispersions expressed as P(90) were estimated in the presence of acetylcholine. Stimulation-evoked EPCs with long release latencies increased in number when acetylcholine was applied. P90, which is designated as the interval between the minimal synaptic delay and the time at which 90 per cent of all measured uni-quantal EPCs had occurred, was significantly and reversibly increased by 66 per cent from 0.51 ms to 0.85 ms in the presence of 5x10(-4) M acetylcholine. This indicates that the evoked release pattern is less synchronous and the increased asynchrony leads to a substantial drop (by 28 per cent) in the amplitude of reconstructed multi-quantal currents.

Acetylcholine↗
PubMed2003

[Laparoscopic extirpation of the rectum--initial experience].

Laparoscopy is still more and more widespread in surgery. It's advantages and disadvantages are still evaluated. It is very complicated to evaluate positive and negative characteristics of laparoscopy. Only to make the indication case to case is the correct approaches in using laparoscopy in abdominal surgery.

Aged↗
PubMed2003

[Omentoplasty of the sternum--surgical solution in a sternal defect due to sternal osteomyelitis in a female patient with mediastinal localization of a parathyroid adenoma. Case report].

We report here the case report of patient with empyema of the thorax and sternal osteomyelitis, which undertool removal of ectopic mediastinal parathyroid adenoma with omentoplasty of sternal defect. Osteomyelitis was cured; though empyema persisted for several months and it's healing was complicated with central venous catheter sepsis.

Adenoma↗
PubMed2002

[Personal experience with a bilateral approach in the surgical treatment of primary hyperparathyroidism. (A group of 222 patients with surgery for primary hyperparathyroidism from 1994 to 2000)].

Surgical treatment offers a definite cure of patients with primary hyperparathyroidism. When making the diagnosis of primary hyperparathyroidism the success of a surgical solution depends on the experience and judgment of the surgeon. Our experience with 222 operations and re-operations convinced us on the preference of a bilateral approach, i.e. exploration of both sides of the neck. The ectopic localization of the parathyroid glands, the limited possibilities of an unequivocal interpretation of the histological examinations but also the frequent incidence of thyropathies leads the surgeon, in our opinion, to the complete exploration of both sides of the neck within the framework of the primary operation for primary hyperparathyroidism. This approach leads most probably to the best results. We use an aimed unilateral approach only in old patients who are in a very bad condition where we anticipate a benefit from a short operation.

Adolescent↗
PubMed2000

[Importance and reliability of preoperative localization in primary hyperparathyroidism].

On the basis of experience with a group of 176 performed operations for primary hyperparathyreosis at the 3rd Surgical Clinic of 1st Medical Faculty of Charles University in Prague in cooperation with the 3rd Internal Clinic of 1st Medical Faculty of Charles University in Prague, we together share the opinion to perform necessary preoperative localization examinations. Sonography is routinely performed and after evaluation of its objective result scintigraphy and MRI is individually indicated. Preoperative localization of adenomas shortens the time of operative procedure. Sufficient experience with preoperative localization examinations become more important especially in the diagnosis before reoperations of parathyroidal adenomas which are sometimes necessary.

Adenoma↗
PubMed2000

[Surgical problems in primary hyperparathyroidism with concomitant nodular goiter].

In our group of 176 performed operations with diagnosis of primary hyperparathyreosis during the period of 1994-1999 present thyreopathy has been established peroperatively as well as postoperatively in altogether 47% of patients. Due to high percentage of coincidence of these diagnoses the condition of establishing indication for surgical therapy appears to be necessary not only on parathyroidal glands, but also determining the extent of resection on the thyroidal gland. In terms of preoperative screening, besides usual investigation of sonography and scintigraphy, we can recommend MRI test, which is highly positive for patients with thyreopathy, particularly in the area of nodular thyroid mass. The advantage of MRI investigation enables more precise localization of ectopic parathyroidal adenoma.

Adenoma↗
PubMed2000

[Surgical approach in mediastinal adenomas and parathyroid carcinomas].

The authors performed retrospective analysis of medical records in a group of 176 patients, who underwent surgical treatment of primary hyperparathyroidism. Surgical strategy was the major issue of interest. Cervical collar incision represented a first-choice approach to cervical exploration in most of cases except those, in whom ectopic mediastinal localization have been diagnosed before the operation. Partial sternotomy was the most common option in surgical re-explorations as a second step following failed parathyroid surgery. We conclude that partial sternotomy is necessary further step in patients with primary hyperparathyroidism complicated by malignant hypercalcaemia on condition that the surgeon is not able to reveal adenomas from neck exploration and sternotomy is than performed immediately during the same operation.

Adenoma↗
PubMed1999

Surgical therapy of thymomas.

Surgical treatment of thymomas is indicated for Masaoka stage 1 to 3. We are not in favor of mini-invasive techniques. We consider a gold standard to be sternotomy followed by a tumor removal and extended thymectomy. We are convinced it is necessary to perform sternotomy, tumor removal and extended thymectomy after a thymoma resection through thoracotomy to prevent a late onset of myasthenia gravis. In stages 2 to 3 actinotherapy along with chemotherapy should follow surgery to increase the patient's chances for a prolonged survival (Tab. 10).

Humans↗
PubMed1994

[Personal experience with the stress test before thoracic surgery procedures].

Physical loads can to a certain extent the surgical stress and postoperative load. Since 1987 the authors started to use loading tests when evaluating the surgical risk and during the preoperative preparation of patients before surgery of the lungs and before two-cavity operations in oesophageal disease. Since 1989 the authors used in patients 2-minute isotemporal graded submaximal loading tests on a bicycle ergometer with three-minute breaks between individual loads. The tested patients were high risk patients-ASA 3-4. From the investigation ensues that a major surgical operation greatly increases the specificity and reduces the false positivity of the preoperative loading examination. Detection of functional fitness or functional reserves of the cardiovascular and cardiopulmonary system before operation leads to a more aimed preoperative preparation and postoperative therapy. Indications for major surgery in high risk patients is according to the authors' experience an even more marked impulse for preoperative loading tests than the patient's age. In 60-year-old patients and older ones the loading tests are also very valuable from the clinical aspect; the authors, however, were not able to prove the necessity of routine testing of this group of patients before every surgical operation. In these instances in indication for a loading tests the opinion of the specialist for internal medicine will be decisive.

Adult↗
PubMed1990

[Removal of pulmonary metastases using the Nd:YAG laser].

The authors submit a case-history on their first successful application of a Nd:YAG laser in pulmonary surgery. They operated a 17-year-old boy with metastases of a synovial sarcoma in both wings of the lungs. First the boy was operated on the left side by the classical technique, half a year later the authors used a Nd:YAG laser on the right side. By means of the laser four metastases were removed. The postoperative course was without complications. One month after operation the patient was discharged from the care of oncologists and was free of complaints. The authors compare the surgical techniques and the postoperative course of the patient. A Nd:YAG laser is a suitable supplement of the equipment of pulmonary surgeons. Since the described case the authors used the laser in same indication in another three patients.

Adolescent↗
PubMedDate not supplied

Changes in abdominal wall after mesh implantation in rats.

On an incisional hernia model, we evaluated tissue reactions to three types of non-absorbable foreign materials, Prolene, Gore-Tex and flax, used for covering defects of the abdominal wall muscles in Wistar strain rats. The examinations were carried out in five 14-days intervals between the 35th and 91st days after the intervention. Our results with Gore-Tex showed the lowest tissue response, the lowest inflammatory cellular as well as fibroplastic reaction, it also completely covers the artificially made wall defect and induces no considerable peritoneal adhesion. In defects filled with Prolene mesh, we also observed no considerable cellular response and scarring. However, considerable peritoneal adhesions were found and the defect was filled to a great extent with lipidic tissue with irregularly distributed Prolene fibres. The use of flax material is least suitable since it induces extensive inflammatory reactions, which occur even after a very long time after the operation. Prolene was, as a matter of fact, second to Gore-Tex in the experimental evaluation of the biological tolerance. However, with respect to its ten times lower price, it can be recommended as a material of the first choice for covering defects of the abdominal wall in clinical use.

Abdominal Muscles↗